This pilot study suggests that an additional evaluation of choline supplementation as an intervention for memory functioning in children with FASDs is warranted. The observed interaction between age and choline's effect on EI suggests that potential sensitive periods should be considered in future work. This trial was registered at clinicaltrials.gov as NCT01149538.

Of major interest to those concerned with early mnemonic process and function is the question of whether early memories likely encoded without the benefit of language later are accessible to verbal report. In the context of a controlled laboratory study, we examined this question in children who were 16 and 20 months at the time of exposure to specific target events and who subsequently were tested for their memories of the events after a delay of either 6 or 12 months (at 22–32 months) and then again at 3 years. At the first delayed-recall test, children evidenced memory both nonverbally and verbally. Nonverbal mnemonic expression was related to age at the time of test; verbal mnemonic expression was related to verbal fluency at the time of test. At the second delayed-recall test, children evidenced continued accessibility of their early memories. Verbal mnemonic expression was related to previous mnemonic expression, both nonverbal and verbal, each of which contributed unique variance. The relevance of these findings on memory for controlled laboratory events for issues of memory for traumatic experiences is discussed.

There are no biological treatments for fetal alcohol spectrum disorders (FASD), lifelong conditions associated with physical anomalies, brain damage, and neurocognitive abnormalities. In pre-clinical studies, choline partially ameliorates memory and learning deficits from prenatal alcohol exposure. This Phase I pilot study evaluated the feasibility, tolerability, and potential adverse effects of choline supplementation in children with FASD. We hypothesized that choline would be well-tolerated with minimal adverse events. The study design was a double-blind, randomized, placebo-controlled trial. Participants included 20 children, ages 2.5–4.9y, with prenatal alcohol exposure and FASD diagnoses. Participants were randomly assigned to 500 mg. choline or placebo daily for nine months (10 active; 10 placebo). Primary outcome measures included feasibility, tolerability, adverse effects, and serum choline levels. Seventeen participants completed the study. Compliance was 82–87% as evidenced by parent-completed logsheets and dose counts. Periodic 24-hour dietary recalls showed no evidence of dietary confounding. Adverse events were minimal and were equivalent in the active and placebo arms with the exception of fishy body odor, which occurred only in the active group. There were no serious adverse events to research participants. This Phase I pilot study demonstrates that choline supplementation at 500 mg per day for nine months in children ages 2–5 is feasible and has high tolerability. Further examination of the efficacy of choline supplementation in FASD is currently underway.

Children adopted from institutions have been studied as models of the impact of stimulus deprivation on cognitive development (Nelson et al., 2011), but these children may also suffer from micronutrient deficiencies (Fuglestad et al., 2008). The contributions of iron deficiency (ID) and duration of deprivation on cognitive functioning in children adopted from institutions between 17 and 36 months of age were examined. ID was assessed in 55 children soon after adoption, and cognitive functioning was evaluated 11–14.6 months post-adoption when the children averaged 37.4 months old (SD = 4.9). ID at adoption and longer duration of institutional care independently predicted lower IQ scores and executive function (EF) performance. IQ did not mediate the association between ID and EF.